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MSK > ELBOW > Flashcards

ELBOW Flashcards

1
Q

what are the movement dx for the elbow

A

tissue impairment
nerve entrapment

wrist ext with pronation
wrist flexion with pronation
hypomobility
elbow flexion syndrome
valgus syndrome
elbow extension syndrome

H E E F F V

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2
Q

acute tissue injury in the inflammed state would be what mvmt dx

A

tissue impairment

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3
Q

explain wrist extension with pronation syndrome

A

the wrist extensors and pronators are overused.
there is LATERAL elbow px.
px with gripping
associated with scap abd

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4
Q

dx related to wrist extension/prontation syndrome

A

lateral epicondylitis
LCL sprain
extensor sprain

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5
Q

what nerve can be stressed with repetitive elbow flexion

A

ulnar

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6
Q

wrist flexion with pronation syndrome, px is usually where

A

medial elbow

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7
Q

explain wrist flexion with pronation syndrome

A

overuse of wrist flexors and pronators

medial elbow px

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8
Q

pathologies assct. with wrist flexion and pronation syndrome

A

medial epicondylitis

flexor strains

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9
Q

medial epicondylitis is aka

A

golfer’s elbow

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10
Q

lateral epicondylitis is aka

A

tennis elbow

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11
Q

fractures, dislocation, recent surgery (but not in acute inflammatory stage) would be what mvmt sx dx

A

elbow hypomobility

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12
Q

with hypomobility, ____ is lost the most

A

elbow flexion

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13
Q

explain elbow flexion syndrome

A

repetitive elbow flexion causes numbness or tingling in the hand
there is usually sensory loss before motor
can result in CLAW hand

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14
Q

what muscle is often tight with elbow flexion syndrome

A

FCU

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15
Q

what pathologies are related to elbow flexion syndrome

A

cubital tunnel syndrome

ulnar nerve irritation

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16
Q

valgus stress syndrome usually causes a tight

A

pronator teres

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17
Q

pathologies assct. with valgus syndrome

A 
MCL sprain
ol. bursitis
could be med. epicondylitis (if valgus stress caused)
triceps tendon
valgus extension overload syndrome
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18
Q

explain elbow extension syndrome

A

there is post elbow px at end range ext

there can be elbow hyper or hypo ext

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19
Q

what dx are assct with elbow ext syndrome

A

ol. bursitis
triceps
post fxs or dislocations

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20
Q

if issue is throbbing px, you have to look into possible

A

nerve entrapment

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21
Q

wrist flexors originate at the

A

medial epicondyle

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22
Q

brachioradialis origin

A

humerus

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23
Q

brachioradialis axn

A

flex
pronates
supinates

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24
Q

pronator teres runs from ___ to ___

A

ulna to radius

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25
Q

brachioradialis N

A

radial

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26
Q

most wrist flexors are ___ N

A

median (except FCU is ulnar)

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27
Q

active supination causing sx to the elbow (lat), why would this make sense

A

one of the origins is lateral epicondyle (if person has lateral epicondylitis, active supination can cause sx)

also, radial N entrapment can flare with supination

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28
Q

4 muscles that may show weakness dt radial N entrapment (the kind that has motor sx)

A

extensor digatorum
Abductor PL
and EPL/Brevis

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29
Q

one very simple thing to tx nerve entrapment

A

if there is a specific muscle that is entrapping, stretch it to take off compression

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30
Q

simple concept to tx strain

A

stretch the side (or muscle) that is strained

strengthen the antagonist muscle

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31
Q

N to the pronators

A

median

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32
Q

N to supinator

A

radial

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33
Q

N to extensors of wrist

A

radial

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34
Q

wrist extensors origin is the

A

lateral epicondyle

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35
Q

if pt lacks supination, what may be too tight

A

antagonists (pronators)

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36
Q

during ext, ulna moves ____

A

Ulna moves laterally during extension, due to articular groove and distal medial aspect

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37
Q

normal carrying angle men

women

A

men 5-15

women 15-20

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38
Q

this resists valgus force

A

MCL or UCL

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39
Q

the two bands of the MCL and what they resist

A

ant - flex and ext

post - flexion only

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40
Q

resting position HU joint

A

70 degrees of flexion, with 10 degrees of supination

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41
Q

closed packed HU joint

A

full ext and supination

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42
Q

capsular pattern HU joint

A

flexion is more limited

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43
Q

the ___ Ligg provides a sling around the radial head

A

annular

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44
Q

HR joint resting position

A

Full extension and forearm supination

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45
Q

HR joint closed packed

A

90 degrees of elbow flexion and 5 degrees of supination

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46
Q

HR joint capsular pattern

A

Flexion > extension, equal limitation of pronation and supination is observed

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47
Q

proximal RU joint open pack

A

70 degrees of flexion and 35 degrees of forearm supination

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48
Q

proximal RU joint capsular

A

pronation = supination, minimal to no loss of motion, with pain at the end ranges of pronation and supination

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49
Q

these structures provide stability to distal RU joint

A

Interosseus membrane
Articular disc
Anterior radioulnar ligament
Posterior radioulnar ligament

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50
Q

annular lig and interossei provide stability to the ___RU joint

A

proximal

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51
Q

Ulnar abduction occurs with ___ and ___

A

pronation and ext

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52
Q

ulnar adduction occurs with ___ and __

A

sup and flexion

53
Q

arc of motion is ___ to ___

A

30 - 130

54
Q

ulnar nerve goes through the ___

A

cubital tunnel

55
Q

___ and ___ cause stress on the ulnar nerve

A

flexion and valgus

56
Q

ulnar nerve sensation loss would be felt where

A

pinky and wring finger (palmar and dorsal sides)

57
Q

where is median nerve sensation loss

A

palmar side of thumb, then digit 2 and 3

58
Q

median nerve trapped at forearm is ___

median nerve trapped at wrist is___

A

forearm - pronator teres syndrome

wrist - carpal tunnel

59
Q

radial N sensory loss is where

A

lateral, post forearm

backside of hand and forearm

60
Q

carrying angle over 25 is considered

A

cubital valgus

61
Q

post interosseus N issues are associated with more motor or sensory

A

motor

62
Q

post interosseus N issues will manifest how

A

will have probs with thumb ext or MCP ext. (thumb abd or digit extensors)

63
Q

epicondylitis vs algia

A

itis infers that there is current inflammation, algia is preffered over itis

64
Q

which is more common lateral or medial epicondylitis

A

lateral

65
Q

main muscle involved in lateral epicondylitis

A

ED

66
Q

repetitive wrist extension and/or grasping that causes

Dull ache at rest, sharp pain at lateral epicondyle with lifting

A

lat epicondylitis

67
Q

deep friction massage is a good tx for

A

epicondylitis

68
Q

2 main muscles for medial epi

A

FCR and pronator teres

69
Q

cubital tunnel syndrome, there are motor changes with

A

adductor pollicis

70
Q

epiphisitis of medial epicondyle

A

LLE (little leaguers elbow)

71
Q

LLE (little leaguers elbow) sx

A

Loss of full extension of elbow

Pain with resisted flexion

72
Q

why is there px with resisted flexion with LLE

A

bc the flexors originate at medial epcicondyle

73
Q

Affects growth, ossification centers in children
Begins as degeneration or necrosis of capitellum (lateral humerus) and followed by regeneration, recalcification (similar to legg calve perth of hip)

A

panners disease

74
Q

if you suspect panners, never do a ____ force

A

valgus

75
Q

Loss of blood supply as a result of traumatic injury like compression forces. (lateral compressive force)

Has popping and clicking

A

osteochondritis dissecans

76
Q

biceps rupture is usually (prox or distal)

A

distal (from quick forceful contraction)

77
Q

dorsal side of hand is mostly ___ N

A

radial (not including distal fingers)

78
Q

what is cubital tunnel syndrome

A

ulnar nerve compression distal to the medial epicondyle

79
Q

cubital tunnel syndrome can sometimes present with

A

claw hand

80
Q

repetitive elbow ____ causes cubital tunnel

A

flexion

81
Q

weak pinch grasp is indicative of

A

cubital tunnel

82
Q

parathesia in thumb, index and middle finger

A

median N

83
Q

radial tunnel syndrome vs radial N compression by supinator

A

radial tunnel syndrome is at the elbow (compressed at radial head)

if it is compressed by supinator it is called post Int. N compression

Post interosseus - motor sx
radial tunnel syndrome - sensory sx

84
Q

radial tunnel syndrome presents with sensory sx where

A

back of forearm

85
Q

what is typically torn in a disclocated elbow (radial head)

A

annular lig

86
Q

tommy john surgery is for

A

MCL

87
Q

ext valgus overload syndrome involves what structures

A

compression of olecranon on the humerus

88
Q

where is px with ext valgus overload syndrome

A

post elbow (AROM ext PROM pronation)

89
Q

most common elbow injury in adults

A

radial head fx

90
Q

most common elbow fx in children

A

supracondylar

91
Q

pronators are ___ N

A

median

92
Q

numbness and tingling at 4th and 5th digit think

A

cubital tunnel syndrome

93
Q

Pain in the volar (palmar) aspect of forearm into the index and middle finger; parasthesia in thumb, index finger, middle finger aggravated with activity

A

pronator teres syndrome

94
Q

tenderness distal to lateral epicondyle and motor sx to the extensors of thumb or digits

A

post interosseus N issues

95
Q

medial glide of HU joint helps with

A

flexion and add

96
Q

lateral glide of HU joint helps with

A

ext abd

97
Q

medial gap of HU joint helps with

A

flex
ext
pron

98
Q

lateral gap of HU joint helps with

A

flex
ext
pron

99
Q

HR joint dorsal/post glide helps with

A

ext (these you are on the radial head)

100
Q

HR volar/ant glide helps with

A

flexion (you are on the radial head)

101
Q

Proximal RU joint post glide helps with

A

pronation

102
Q

proximal RU joint ant glide helps with

A

supination

103
Q

Distal Radioulnar joint post glide helps with

A

supination (and flex/ext of wrist)

104
Q

Distal RU joint ant glide helps with

A

pronation (and flexion/ext of wrist)

105
Q

normal elbow flexion is

A

140

106
Q

normal elbow ext is

A

0

107
Q

normal supination

A

80

108
Q

normal pronation

A

80

109
Q

at the end of shoulder elevation, explain clavicle

A

30-40 degrees of posterior clavicular axial rotation and 30-40 degrees of calvicular elevation

110
Q

2 forms of radial nerve entrapment

A

radial tunnel - no motor loss (px at lat epi and rad. head)

post int. - px is distal, there are motor sx to finger/thumb extensors and add PL

111
Q

open packed pos for prox RU

A

70 flexion 35 sup

112
Q

open packed for distal RU

A

10 sup

113
Q

HR distraction helps with

A

pro and ext

114
Q

mvmt dx lateral epicondylitis or extensors issue

A

wrist ext with pronation

115
Q

ulnar nerve issues at elbow is what mvmt dx

A

elbow flexion syndrome

116
Q

olecranon bursitis is what mvmt dx

A

elbow ext syndrome (which is really px that is caused by end range elbow ext)

117
Q

so cubital tunnel presents with both sensory and ___

A

motor
sensory to ulnar N distritubtion
motor to adductor pollicis

118
Q

list the 7 hand muscles innervated by ulnar nerve

A 
Adductor pollicus
FCU
ABD DM
Flexor DM
OPP DM
3 and 4 lumbricals
interossei
119
Q

Pain over lateral elbow during gripping activities

A

lat epicondylitis or radial N

120
Q

numbness tingling to ulnar nerve distal to ulna itself think

A

cubital tunnel syndrome

121
Q

post interosseius N is a branch of

A

radial - does all extensors and snuff box

122
Q

both gap mobs help with

A

FEP

123
Q

list the nerve pathologies (all)

A

radial - radial tunnel syndrome (at radial head) sensory sx
- post interosseius issues (at supinator) motor sx to
forearm extensors

Median - carpal tunnel syndrome at wrist
- pronator teres syndrome at forearm

Ulnar - cubital tunnel syndrome at elbow
- tunnel of guyon at hand

124
Q

for HR glides, you MUST be (their position)

A

fully extended and supinated

125
Q

for HR post glide they are

A

full palm up/supine

126
Q

for HR ant glide they are

A

thumb up, elbow straight

127
Q

what does a lateral HU glide facilitate

A

ext and abd

128
Q

panners is on what side

A

lateral elbow

MSK (10 decks)

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